Evidence map›Paper›PMID 40642387›Full record

ReviewFrontiers in molecular neuroscience2025

Decoding pain chronification: mechanisms of the acute-to-chronic transition.

Shunwei Zhang, Youzhi Ning, Yiyi Yang, Guo Mu, Yongkui Yang, Changhe Ren, Changli Liao, Cehua Ou, Yue Zhang

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Frontiers in molecular neuroscience, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Shunwei Zhang *Department of Pain Management, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Youzhi Ning *Department of Pain Management, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Yiyi YangSouthwest Medical University, Luzhou, China.
Guo MuDepartment of Anesthesiology, Zigong Fourth People's Hospital, Zigong, China.
Yongkui YangDepartment of Pain Management, Hejiang People's Hospital, Luzhou, China.
Changhe RenDepartment of Pain Management, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Changli LiaoDepartment of Science and Technology, Southwest Medical University, Luzhou, China.
Cehua OuDepartment of Pain Management, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Yue ZhangDepartment of Pain Management, The Affiliated Hospital of Southwest Medical University, Luzhou, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Pain chronification is a multidimensional and active pathophysiological process, not merely a consequence of prolonged nociception. This review proposes a four-domain mechanistic framework to elucidate the transition from acute to chronic pain. At the molecular-cellular level, persistent neuroinflammation-driven by activated glial cells and pro-inflammatory mediators such as TNF-α and IL-1β-leads to peripheral and central sensitization through enhanced excitability and ion channel dysregulation. In parallel, epigenetic mechanisms such as DNA methylation and histone modifications alter the expression of pain-related genes (e.g., SCN9A, BDNF), establishing a long-term transcriptional predisposition to chronic pain. These changes converge on maladaptive neural plasticity, characterized by aberrant synaptic strengthening, cortical map reorganization, and disrupted functional connectivity, which embed pain into persistent network states. Moreover, psychosocial factors-including catastrophizing, affective distress, and impaired top-down regulation-amplify pain through feedback loops involving the prefrontal cortex, amygdala, and hypothalamic-pituitary-adrenal (HPA) axis. By integrating these four interconnected domains, we highlight critical windows for mechanism-informed, temporally targeted interventions that may interrupt pain chronification and enable a shift toward proactive, personalized pain prevention.

Indexed as

biomarkersepigenetic regulationneuroinflammationneuroplasticitypain chronification

Identifiers

PMID40642387
PMCPMC12241141

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.